Transient Ventricular Wall Thickening in Acute Myocarditis : A Serial Echocardiographic and Histopathologic Study

概要

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The present study was designed to determine whether the wall thickening seen in acute myocarditis is caused by interstitial edema. The study group comprised 25 patients(idiopathic myocarditis, 17; eosinophilic myocarditis, 8)in whom acute myocarditis was diagnosed histologically and who underwent echocardiography and endomyocardial biopsy during both the acute and convalescent phases. The following echocardiographic parameters were measured: interventricular septum and left ventricular posterior wall thickness, left ventricular end-diastolic dimension, and left ventricular ejection fraction. Based on the myocardial biopsy specimens, the degree of interstitial edema was classified into 3 grades[(-), 1(+), 2(+)]and the transverse diameter of cardiac myocytes was measured using light microscopy. The thickness of both the interventricular septum and left ventricular wall decreased from 14.3±3.7 mm and 13.3±2.4 mm in the acute phase to 9.7±1.7 mm(p<0.001)and 10.2±1.7 mm(p<0.0001), respectively, in the convalescent phase. Edema was present in 22 patients(88.0%)in the acute phase, but in the convalescent phase, edema was present in only 7 patients(28.0%), indicating a significant reduction in the degree of edema(p<0.0001). Cardiac myocyte diameter did not differ significantly between the acute(13.6±1.1μm)and convalescent(13.8±1.8μm)phases.
社団法人日本循環器学会の論文
2001-09-20